The Missing point in the diagnosis: 1- heavy smoker: increases risk of vascular damage or play significant role in worsening atherosclerosis and vascular damage lead to vascular luminal narrowing 70 % lead to TIA 2- The ABCD² Score to estimate or predict the risk of stroke following TIA : In this cases : 0 (age ) + 1(BP ) + 2 ( clinical features or unilateral weakness) + 0 ( Aphasia) + 1 ( diabetes) + 1 ( duration) = 5 This patient has moderate risk of stroke ( 4 % in 2 days ) Admission to hospital to observation , follow up and Urgent evaluation and management . 3- determined to affected area or blood vascular: inability to speak ( aphasia) results affecting in the Broca's area and the left middle cerebral artery supplies Broca's area in frontal lobe and Wernicke's area in the temporal lobe , both of which are critical for speech production and comprehension. -Cerebral blood vessels spasm
Missing point: ABCD² score: in this case 5 points ( moderate) . Heavy smoker . Weakness occur while at work. Vascular artery that affected ( left middle cerebral artery) . Lacunar stroke due to hypertension ( most common cause) . Lenticulostriate branches arteries . Atherosclerosis in carotid or it's branches arteries
1) Clinical Diagnosis: Transient Ischemic Attack (TIA) secondary to metabolic syndrome. 2) Anatomical Diagnosis: TIA affecting the left middle cerebral artery (dominant hemisphere). 3) Etiological Diagnosis: Non-cardioembolic TIA due to atherosclerotic disease of the left carotid artery. 4) Diagnosis of the Stage: Acute moderate risk TIA with no permanent deficits (ABCD² score: 5). - Metabolic syndrome (hypertension, diabetes, abdominal obesity) complicated by an acute cortical TIA involving the left MCA cortical branch, affecting the frontal lobe (including Broca's area, area 44) and adjacent motor cortex, presenting as transient right-sided hemiparesis and Broca's aphasia, likely due to atherosclerosis of the left carotid artery.
- Risk stratification using the ABCD² score can help predict stroke risk after TIA (As one third of people who had a TIA will develop stroke.): Age (0) + Blood pressure (1) + Clinical features (2) + Duration (1) + DM (1) = 5 moderate risk, need secondary prevention to avoid stroke. - Additionally, given the patient's metabolic syndrome and heavy smoking history, there is a significant risk of systemic atherosclerosis affecting multiple vascular territories. This includes a high risk of coronary artery disease (CAD), as well as potential involvement of the mesenteric arteries, peripheral artery disease (PAD), and renal artery stenosis, all of which should be carefully examined. عمر الصدفي +201050019610
هنيئًا لمصر بحضرتك يا دكتور، كل التحايا لك ولكل متابعيك حقيقة مبادرة مشجعة جدا وجائزة قيمة ولولا أني من العراق لوددت حقا المشاركة في مؤتمر مع حضرتك يا دكتور.. كم استفدت منك وما زلت استفيد، جزاك الله خير الجزاء
TIA Carotid type Non-Cardioembolic. I think the missing point in diagnosis is the level of ischemia"which part is affected" 1- *If it was Cortical ischemia it's usually monoparesis or monoplagia* and the case is hemiparesis. 2-If it was crona radiata ischemia... stmilar to Cortical. These areas to be affected and cause hemiparesis... need ischemia of large part of Cortex or Crona radiata and the patioat Conscious level may be disturbed at this time. 3-If it was internal Capsule ischemia "where fibers are Combact "...usually lead to hemiparesis"incomplete whit no facial affection as facial nucleus is bilaterally supplied"...and in this Case patient was unable to to speak at all due to affection of speech area but if was due to facial affection,it would be dysarthria. *So, findings support ischenta of internal capsule .* 4-If ischemia was in the brain stem... Hemiparesis with facial affection due to Vertebro-basilar ischemia in form of dysarthria and we have already disproven it. Note: Aphasia means cortical affection but if it's purely cortical affection... would be associated with disturbed conscious level for example which is not mentioned in this case So,TIA due to MCA ischemia causing mixed cortical and subcortical affection.
And the lesion is probably in the left superiordivision of middle cerebral artery : AS there is rt. hemiparesis (UL+LL) (frontal lobe)+APHASIA(brocas area) +No visual disturbance+ No hemihyposthsia +MCA is the most common affected artery in these cases due to atherosclerotic cerebrovascular disease
A transient ischemic attack (TIA) is often referred to as a "mini-stroke." It involves a temporary disruption of blood flow to the brain, causing stroke-like symptoms that typically resolve within 24 hours. TIAs serve as a warning sign for a potential future stroke. Proper diagnosis usually requires a medical professional to evaluate symptoms, which may include sudden numbness or weakness, confusion, trouble speaking, or loss of balance. Immediate medical attention and further diagnostic tests such as imaging (MRI or CT scans) or ultrasound of the carotid arteries are essential to confirm the diagnosis and prevent future complications.
The missing part is risk stratification According to Canadian tia score Is a high risk patient for developing stroke Need more assessment measures to prevent stroke
1. Functional Diagnosis: TIA is characterized by temporary neurological dysfunction without lasting deficits but with (a MODERATE RISK) score of 5 for developing stroke according to The ABCD2 score as follows: • Age: 0 points. • Blood Pressure: 1 point. • Clinical features: 2 points (unilateral weakness). • Duration: 1 point • Diabetes: 1 point 2. Etiological Diagnosis: The most likely etiology is noncardioembolic atherosclerotic thromboembolism according to the patient’s risk factors: Hypertension, diabetes, and smoking. 3. Anatomical Diagnosis (Site of the lesion ): The left hemisphere of the brain in the middle cerebral artery (MCA) the main artery, not the branches as it affects more than one area away from each other 1-Contralateral hemiplegia 2-Aphasia 4. Pathological Diagnosis: - Transient ischemia caused ATH narrowing of the MCA branch of the carotid system due to plaque formation. Clinical diagnosis is transient Hemiparesis in a metabolic syndrome patient due to TIA in the form of transient hemiparesis (right-sided weakness) and aphasia due to temporary ischemia in the left middle cerebral artery (MCA), likely caused by noncardioembolic atherosclerotic thromboembolism resulting from the patient’s hypertension, diabetes, and smoking. The ischemic event is due to the narrowing of the MCA due to atherosclerotic plaque formation in the carotid system. The patient has a moderate risk of stroke, with an ABCD² score of 5, indicating a need for urgent evaluation and management. عبدالرحمن محمد الرفاعي 01013946192
the presence of Aphasia indicate that it was a cortical hemiparesis rather than capsular and the affected artery is the middle cerebral artery so, the full diagnosis will be (( Metabolic syndrome complicated by non cardioembolic carotid TIA affecting the middle cerebral artery and manifested by cortical hemiparesis ))
The symptoms described in this patient suggest the involvement of the left middle cerebral artery (MCA) territory, which supplies specific regions of the brain responsible for motor function and language. Key Findings Supporting Left MCA Territory Involvement: 1. Right-sided weakness (right upper and lower limbs): The primary motor cortex (precentral gyrus) located in the frontal lobe is affected. The left hemisphere controls the motor function of the right side of the body. The upper limb and face are predominantly represented in the lateral aspect of the motor cortex supplied by the MCA. 2. Inability to speak (aphasia): The Broca's area (in the dominant hemisphere, typically left in right-handed individuals) is involved. The left MCA supplies Broca's area in the frontal lobe and Wernicke's area in the temporal lobe, both of which are critical for speech production and comprehension. In conclusion what was affected in this patient Motor cortex: Causing contralateral (right-sided) weakness. Broca's area: Causing expressive aphasia (inability to speak). This pattern in this patient strongly suggests an ischemic event in the left MCA superior division, which supplies the lateral frontal lobe, including the motor cortex and Broca's area. الاسم محمد أحمد عبدالله محمد رقم التليفون 01090160039
From the risk factors this is large vessel disease not lacunar and we know this is non cardioembolic so mostly atherosclerotic to carotid transient blockage make hypoperfusion to it's branch mainly left middle cerebral artery (MCA) particularly its superior division(Supplies the frontal lobe including Broca’s area and parts of the motor cortex) is the most likely artery affected in this case given the right sided weakness and speech difficulty
Metabolic syndrome complicated by carotid non embolic TIA due to affection of superior branch of middle cerebral artery moderate risk according to ABCD2 score (5 points) with recommended admission for further evaluation
the missing part (affecting the dominant hemisphere which is in this case the left hemisphere as the patient suffer from a aphasia and contralateral (right) hemiparesis )
the main missing point is this Diagnosis is the Anatomical diagnosis (levelling ) or in other words where is the lesion ? *** the lesion occurred at cerebral-subcortical ( Corona radiata ) on the left hemisphere *** presence of complete complete complete rt hemiparesis from the start and Aphasia suggests subcortical hemiplegia and by which we can also exclude other possible diagnoses: 1) Cortical hemiparesis ( which start as monoplegia not hemi but it may or may not ... may or may not progress to hemiplegia) 2) Capsular hemiparesis which easily excluded by aphasia which is a cortical sign. And if it was a complete artery occlusion of MCA the both upper and lower limbs will be affected simultaneously but upper limb is more affected than lower but here in the case both limbs are affected to the same extent !! Other missing points in the diagnosis include Clinical diagnosis , prognosis and the affected artery as following • Clinical : complete right hemiparesis with aphasia • Prognosis : the patient has a moderate risk for developing Stroke : According to ABCD2 Score : A= 0 B = 1 C= 2 D duration = 1 D diabetes = 1 the patient score = 5 which interpretated as moderate risk for developing stroke. • And the affected artery is left Middle Cerebral Artery طبعا مفيش فرق بين hemiparesis and hemiplegia الفرق بس فال severityyy الاسم : عبدالرحمن محمود عبدالله الموبايل : 01155446105
We need to exactly locate the site of the non-cardioembolic carotid TIA. As there’s aphasia & contralateral paresis with NO NO NO NO visual symptoms it’s mostly the superior branch of the MCA. We can be 100% sure by imaging (MRI).
Given HTN and DM , it could be TIA due to lacunar stroke because it’s pure motor but aphasia makes it unlikely because it’s cortical sign . So , given right sided weakness and Boca aphasia , the affected artery is the superior branch of middle cerebral artery . So the complete diagnosis is metabolic syndrome complicated by carotid TIA OF superior branch of left middle cerebral artery
1-METABOLIC SYNDROME 2-COMPLICATED BY CAROTID TIA 3-NON-CARDIOEMBOLIC TIA 4-ABCD 2 SCORE FOR TIA = 5 POINTS = MODERATE RISK 5-HOSPITAL OBSERVATION JUSTIFIED
We need to exactly locate the site of the non-cardioembolic carotid TIA. As there’s aphasia & contralateral paresis with NO NO NO NO visual symptoms it’s mostly the superior branch of the MCA. We can be 100% sure by imaging (MRI).
The Missing point in the diagnosis:
1- heavy smoker: increases risk of vascular damage or play significant role in worsening atherosclerosis and vascular damage lead to vascular luminal narrowing 70 % lead to TIA
2- The ABCD² Score to estimate or predict the risk of stroke following TIA :
In this cases :
0 (age ) + 1(BP ) + 2 ( clinical features or unilateral weakness) + 0 ( Aphasia) + 1 ( diabetes) + 1 ( duration) = 5
This patient has moderate risk of stroke ( 4 % in 2 days )
Admission to hospital to observation , follow up and
Urgent evaluation and management .
3- determined to affected area or blood vascular: inability to speak ( aphasia) results affecting in the Broca's area and the left middle cerebral artery supplies Broca's area in frontal lobe and Wernicke's area in the temporal lobe , both of which are critical for speech production and comprehension.
-Cerebral blood vessels spasm
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
❤❤
🌹🌷🌷💕
Missing point:
ABCD² score: in this case 5 points ( moderate) .
Heavy smoker .
Weakness occur while at work.
Vascular artery that affected ( left middle cerebral artery) .
Lacunar stroke due to hypertension ( most common cause) .
Lenticulostriate branches arteries .
Atherosclerosis in carotid or it's branches arteries
it is not a lacunar stroke, It's a cerebral stroke due to presence of aphasia
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
1) Clinical Diagnosis:
Transient Ischemic Attack (TIA) secondary to metabolic syndrome.
2) Anatomical Diagnosis:
TIA affecting the left middle cerebral artery (dominant hemisphere).
3) Etiological Diagnosis:
Non-cardioembolic TIA due to atherosclerotic disease of the left carotid artery.
4) Diagnosis of the Stage:
Acute moderate risk TIA with no permanent deficits (ABCD² score: 5).
- Metabolic syndrome (hypertension, diabetes, abdominal obesity) complicated by an acute cortical TIA involving the left MCA cortical branch, affecting the frontal lobe (including Broca's area, area 44) and adjacent motor cortex, presenting as transient right-sided hemiparesis and Broca's aphasia, likely due to atherosclerosis of the left carotid artery.
- Risk stratification using the ABCD² score can help predict stroke risk after TIA (As one third of people who had a TIA will develop stroke.): Age (0) + Blood pressure (1) + Clinical features (2) + Duration (1) + DM (1) = 5 moderate risk, need secondary prevention to avoid stroke.
- Additionally, given the patient's metabolic syndrome and heavy smoking history, there is a significant risk of systemic atherosclerosis affecting multiple vascular territories. This includes a high risk of coronary artery disease (CAD), as well as potential involvement of the mesenteric arteries, peripheral artery disease (PAD), and renal artery stenosis, all of which should be carefully examined.
عمر الصدفي
+201050019610
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
هنيئًا لمصر بحضرتك يا دكتور، كل التحايا لك ولكل متابعيك حقيقة مبادرة مشجعة جدا وجائزة قيمة ولولا أني من العراق لوددت حقا المشاركة في مؤتمر مع حضرتك يا دكتور.. كم استفدت منك وما زلت استفيد، جزاك الله خير الجزاء
مع حضرتك نوري سكرتير دشريف الهواري ممكن لوسمحت تسجل اسمه وتليفونه
TIA Carotid type Non-Cardioembolic.
I think the missing point in diagnosis is the level of ischemia"which part is affected"
1- *If it was Cortical ischemia it's usually monoparesis or monoplagia* and the case is hemiparesis.
2-If it was crona radiata ischemia... stmilar to Cortical.
These areas to be affected and cause hemiparesis... need ischemia of large part of Cortex or Crona radiata and the patioat Conscious level may be disturbed at this time.
3-If it was internal Capsule ischemia "where fibers are Combact "...usually lead to hemiparesis"incomplete whit no facial affection as facial nucleus is bilaterally supplied"...and in this Case patient was unable to to speak at all due to affection of speech area but if was due to facial affection,it would be dysarthria.
*So, findings support ischenta of internal capsule .*
4-If ischemia was in the brain stem... Hemiparesis with facial affection due to Vertebro-basilar ischemia in form of dysarthria and we have already disproven it.
Note:
Aphasia means cortical affection but if it's purely cortical affection... would be associated with disturbed conscious level for example which is not mentioned in this case
So,TIA due to MCA ischemia causing mixed cortical and subcortical affection.
مع حضرتك نوري سكرتير دشريف الهواري ممكن لوسمحت تسجل اسمه وتليفونه
And the lesion is probably in the left superiordivision of middle cerebral artery
: AS there is rt. hemiparesis (UL+LL) (frontal lobe)+APHASIA(brocas area)
+No visual disturbance+ No hemihyposthsia
+MCA is the most common affected artery in these cases due to atherosclerotic cerebrovascular disease
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
A transient ischemic attack (TIA) is often referred to as a "mini-stroke." It involves a temporary disruption of blood flow to the brain, causing stroke-like symptoms that typically resolve within 24 hours. TIAs serve as a warning sign for a potential future stroke. Proper diagnosis usually requires a medical professional to evaluate symptoms, which may include sudden numbness or weakness, confusion, trouble speaking, or loss of balance. Immediate medical attention and further diagnostic tests such as imaging (MRI or CT scans) or ultrasound of the carotid arteries are essential to confirm the diagnosis and prevent future complications.
مع حضرتك نوري سكرتير دشريف الهواري ممكن تسجل الاسم والتليفون لوسمحت
The point that is left is the localization: superior division of the left middle cerebral artery
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
The missing part is risk stratification
According to Canadian tia score
Is a high risk patient for developing stroke
Need more assessment measures to prevent stroke
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
I think the differential diagnosis may be the missed : __ thrombotic ( due to polycythemia) .
__embolic
__ hemorrhagic
__. Hysterical
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
Affection of superior branch of middle cerebral artery
With ABCD2 score moderate risk for admission and follow up ❤❤
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
1. Functional Diagnosis:
TIA is characterized by temporary neurological dysfunction without lasting deficits but with (a MODERATE RISK) score of 5 for developing stroke according to The ABCD2 score as follows:
• Age: 0 points.
• Blood Pressure: 1 point.
• Clinical features: 2 points (unilateral weakness).
• Duration: 1 point
• Diabetes: 1 point
2. Etiological Diagnosis:
The most likely etiology is noncardioembolic atherosclerotic thromboembolism according to the patient’s risk factors:
Hypertension, diabetes, and smoking.
3. Anatomical Diagnosis (Site of the lesion ):
The left hemisphere of the brain in the middle cerebral artery (MCA) the main artery, not the branches as it affects more than one area away from each other
1-Contralateral hemiplegia
2-Aphasia
4. Pathological Diagnosis:
- Transient ischemia caused ATH narrowing of the MCA branch of the carotid system due to plaque formation.
Clinical diagnosis is transient Hemiparesis in a metabolic syndrome patient due to TIA in the form of transient hemiparesis (right-sided weakness) and aphasia due to temporary ischemia in the left middle cerebral artery (MCA), likely caused by noncardioembolic atherosclerotic thromboembolism resulting from the patient’s hypertension, diabetes, and smoking. The ischemic event is due to the narrowing of the MCA due to atherosclerotic plaque formation in the carotid system. The patient has a moderate risk of stroke, with an ABCD² score of 5, indicating a need for urgent evaluation and management.
عبدالرحمن محمد الرفاعي
01013946192
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
I think this is lacunar stroke affect deep branch of basal ganglie because pure motor symptoms and mild weakness
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
the presence of Aphasia indicate that it was a cortical hemiparesis rather than capsular and the affected artery is the middle cerebral artery so, the full diagnosis will be (( Metabolic syndrome complicated by non cardioembolic carotid TIA affecting the middle cerebral artery and manifested by cortical hemiparesis ))
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
full diagnosis is Metabolic syndrome complicated by( TIA ) non cardiombolic TIA , associated with hypertenstion , DM , DYSLIPIDEMIA , and obesity
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
The symptoms described in this patient suggest the involvement of the left middle cerebral artery (MCA) territory, which supplies specific regions of the brain responsible for motor function and language.
Key Findings Supporting Left MCA Territory Involvement:
1. Right-sided weakness (right upper and lower limbs):
The primary motor cortex (precentral gyrus) located in the frontal lobe is affected.
The left hemisphere controls the motor function of the right side of the body.
The upper limb and face are predominantly represented in the lateral aspect of the motor cortex supplied by the MCA.
2. Inability to speak (aphasia):
The Broca's area (in the dominant hemisphere, typically left in right-handed individuals) is involved.
The left MCA supplies Broca's area in the frontal lobe and Wernicke's area in the temporal lobe, both of which are critical for speech production and comprehension.
In conclusion what was affected in this patient
Motor cortex: Causing contralateral (right-sided) weakness.
Broca's area: Causing expressive aphasia (inability to speak).
This pattern in this patient strongly suggests an ischemic event in the left MCA superior division, which supplies the lateral frontal lobe, including the motor cortex and Broca's area.
الاسم محمد أحمد عبدالله محمد
رقم التليفون 01090160039
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
From the risk factors this is large vessel disease not lacunar and we know this is non cardioembolic so mostly atherosclerotic to carotid transient blockage make hypoperfusion to it's branch mainly left middle cerebral artery (MCA) particularly its superior division(Supplies the frontal lobe including Broca’s area and parts of the motor cortex)
is the most likely artery affected in this case given the right sided weakness and speech difficulty
مع حضرتك نوري سكرتير دشريف الهواري ممكن لوسمحت تسجل اسمه وتليفونه
مع حضرتك نوري سكرتير دشريف الهواري ممكن لوسمحت تسجل اسمه وتليفونه
Metabolic syndrome complicated by carotid non embolic TIA due to affection of superior branch of middle cerebral artery moderate risk according to ABCD2 score (5 points) with recommended admission for further evaluation
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
the missing part (affecting the dominant hemisphere which is in this case the left hemisphere as the patient suffer from a aphasia and contralateral (right) hemiparesis )
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
@@dr.sherifelhawary name : Muhammad Ali Badry
من فضلكم هل فيه كورس اونلاين لدكتور شريف الهواري باطنه لطلاب الطب لاني ارغب في التسجيل
مع حضرتك نوري سكرتير دشريف الهواري اه في كورس اونلاين مسجل الاشتراك كلم استاذ رفعت هوالمسوال هيقولك التفاصيل رقمه 01099811125
the main missing point is this Diagnosis is the Anatomical diagnosis (levelling ) or in other words where is the lesion ?
*** the lesion occurred at cerebral-subcortical ( Corona radiata ) on the left hemisphere ***
presence of complete complete complete rt hemiparesis from the start and Aphasia suggests subcortical hemiplegia and by which we can also exclude other possible diagnoses:
1) Cortical hemiparesis ( which start as monoplegia not hemi but it may or may not ... may or may not progress to hemiplegia)
2) Capsular hemiparesis which easily excluded by aphasia which is a cortical sign.
And if it was a complete artery occlusion of MCA the both upper and lower limbs will be affected simultaneously but upper limb is more affected than lower but here in the case both limbs are affected to the same extent !!
Other missing points in the diagnosis include Clinical diagnosis , prognosis and the affected artery as following
• Clinical : complete right hemiparesis with aphasia
• Prognosis : the patient has a moderate risk for developing Stroke :
According to ABCD2 Score :
A= 0
B = 1
C= 2
D duration = 1
D diabetes = 1
the patient score = 5 which interpretated as moderate risk for developing stroke.
• And the affected artery is left Middle Cerebral Artery
طبعا مفيش فرق بين hemiparesis and hemiplegia الفرق بس فال severityyy
الاسم : عبدالرحمن محمود عبدالله
الموبايل : 01155446105
مع حضرتك نوري سكرتير دشريف الهواري ممكن كل واحد من الدكاتره يسجل اسمه وتليفونه لوسمحتو
اليوتيوب بيمسح الكومنت لما بيبقى فيه الرقم كل شويه
بس هو مكتوب مع الاسم فكومنت الاجابه فوق اهوه ☝️
الرقم واضح ولا فيه مشكله ؟@@dr.sherifelhawary
Smoking cessation for completing of treatment plan as well as prevention
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
We need to exactly locate the site of the non-cardioembolic carotid TIA. As there’s aphasia & contralateral paresis with NO NO NO NO visual symptoms it’s mostly the superior branch of the MCA.
We can be 100% sure by imaging (MRI).
انا بقالي ساعة بحاول انزله بس اليوتيوب كان عندي فيه مشكلة😅.
انا حاسس دي أكتر إجابة كاملة ناقص الABCD2 score بس.
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
@@dr.sherifelhawary
اليوتيوب بيشيل الكومينت
دكتور ممكن أحصل الشرح Pdf بعد إذنك يعني
في ميزان حسناتك إن شاء الله
مع حضرتك نوري سكرتير دشريف الهواري لايوجد بي دي إف الكتب موجوده في المكاتب بتاع القصرالعيني
Risk of the developing stroke According to ABCDD score 5 moderate risk
Lt carotid TIA
DD migraine…
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
❤❤❤
لمصرين فقط و لكل الطلبة ؟؟
مع حضرتك نوري سكرتير دشريف الهواري للكل سجل اسمك وتليفونك
لماذا تحذف تعليقاتي ؟؟😢😢😢
Given HTN and DM , it could be TIA due to lacunar stroke because it’s pure motor but aphasia makes it unlikely because it’s cortical sign . So , given right sided weakness and Boca aphasia , the affected artery is the superior branch of middle cerebral artery . So the complete diagnosis is metabolic syndrome complicated by carotid TIA OF superior branch of left middle cerebral artery
👏
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
1-METABOLIC SYNDROME
2-COMPLICATED BY CAROTID TIA
3-NON-CARDIOEMBOLIC TIA
4-ABCD 2 SCORE FOR TIA = 5 POINTS = MODERATE RISK
5-HOSPITAL OBSERVATION JUSTIFIED
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
Metabolic syndrome complicated by carotid TIA..non cardioembolic TIA.. Moderate risk according to ABCD2 score ..
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
The missing is ICA TIA mainly due to atherosclerosis lumen narrowing
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
heavy smoker
is important diagnosis
&risk factor
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك
We need to exactly locate the site of the non-cardioembolic carotid TIA. As there’s aphasia & contralateral paresis with NO NO NO NO visual symptoms it’s mostly the superior branch of the MCA.
We can be 100% sure by imaging (MRI).
مع حضرتك نوري سكرتير دشريف الهواري لوسمحت سجل اسمك وتليفونك